Provider Demographics
NPI:1619597366
Name:SANITAS MEDICAL CENTER OF TENNESSEE PC
Entity Type:Organization
Organization Name:SANITAS MEDICAL CENTER OF TENNESSEE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:DIEGO
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-882-2869
Mailing Address - Street 1:8400 NW 33RD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1937
Mailing Address - Country:US
Mailing Address - Phone:786-882-2869
Mailing Address - Fax:
Practice Address - Street 1:438 N CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7014
Practice Address - Country:US
Practice Address - Phone:663-648-9448
Practice Address - Fax:888-905-2546
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANITAS MEDICAL CENTER OF TENNESSEE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-23
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care